Form LIC 200TM. Temporary Manager Application For Provisional License - California

Form LIC 200TM is used in California for the application of a Temporary Manager for a provisional license. Its main purpose is to gather information and documentation related to the appointment of a temporary manager who will assume responsibility for managing a facility during a transitional period or in specific circumstances.

The form consists of sections where the applicant provides personal information, professional qualifications, and experience relevant to the role of a temporary manager. It may also include details about the facility, such as its name, address, and licensing type. Additionally, the form may require supporting documentation, such as resumes, letters of recommendation, and any other pertinent credentials.

Important fields on this form include accurate and comprehensive information about the applicant's qualifications and suitability for the temporary manager position. It is crucial to provide all required documentation to demonstrate the individual's competence in overseeing the facility during the transitional period.

Application Example: When a provisional license holder in California requires the appointment of a temporary manager, the applicant must complete Form LIC 200TM. By providing the necessary information and supporting documents, the licensing agency can evaluate the applicant's qualifications and make an informed decision regarding the temporary management of the facility.

Related Forms: Form LIC 201, Application for a Community Care Facility or Residential Care Facility for the Elderly License, is a related form used for the initial license application. Form LIC 200TM specifically focuses on the appointment of a temporary manager, while Form LIC 201 covers the broader licensing process for the facility.